Surgery before diabetes develops leads to greater weight loss

Earlier intervention - The study found patients without diabetes had a 1.6 times higher chance than those who already have diabetes of achieving successful weight loss regardless of the surgery type

Patients with obesity may lose more weight if they undergo bariatric surgery before they develop diabetes, according to a study, accepted for presentation at ENDO 2020 (the Endocrine Society's annual meeting that was cancelled due to the COVIUD-19 pandemic), that will be published in a special supplemental section of the Journal of the Endocrine Society.

Both obesity and diabetes are common, with more than one-third of US adults are affected by these two conditions. Among patients that have obesity and diabetes, bariatric surgery can lead to remission of both of these diseases.

"However, which population could have the most benefit from the surgery, and the possible impact of diabetes on the success of their weight-loss surgery is still unknown," said lead researcher, Dr Elif A Oral from the University of Michigan. "Our study suggests that having bariatric surgery before developing diabetes may result in greater weight loss from the surgery, and together with data that is available from other studies, bariatric surgery may potentially prevent or delay diabetes from developing.”

The researchers analysed data from 714 patients in the Michigan Bariatric Surgery Cohort (MI-BASiC) to see whether diabetes before surgery could have any impact on weight loss outcomes five years or more after receiving bariatric surgery. The patients underwent either gastric bypass (380 patients) or sleeve gastrectomy (334 patients). All of the patients either had a a BMI>40 40 or a BMI35-39.9 with diabetes.

The study found patients without diabetes had a 1.6 times higher chance than those who already have diabetes of achieving successful weight loss (defined as achieving excess body weight loss of at least 50% or more) regardless of the surgery type. They also found the presence of diabetes before surgery diminished weight loss by 1.2 BMI points, which is roughly 10-15% of the total BMI points patients lost on average.

Even after adjusting the effect of time, surgery type, age, gender and pre-surgery weight, the absolute weight loss, percentage of total weight loss and percentage of excess weight loss among individuals with diabetes were still significantly lower than individuals without diabetes.